Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Current Diabetes Reports
Published in: Current Diabetes Reports 12/2015

01-12-2015 | Microvascular Complications—Neuropathy (R Pop-Busui, Section Editor)

Exercise as Therapy for Diabetic and Prediabetic Neuropathy

Authors: J. Robinson Singleton, A. Gordon Smith, Robin L. Marcus

Published in: Current Diabetes Reports | Issue 12/2015

Login to get access

Abstract

Length-dependent neuropathy is the most common and costly complication of diabetes and frequently causes injury primarily to small-diameter cutaneous nociceptive fibers. Not only persistent hyperglycemia but also metabolic, endocrine, and inflammatory effects of obesity and dyslipidemia appear to play an important role in the development of diabetic neuropathy. Rational therapies aimed at direct control of glucose or its increased entry into the polyol pathway, oxidative or nitrosative stress, advanced glycation end product formation or signaling, microvascular ischemia, or adipocyte-derived toxicity have each failed in human trials of diabetic neuropathy. Aerobic exercise produces salutary effects in many of these pathogenic pathways simultaneously and, in both animal models and human trials, has been shown to improve symptoms of neuropathy and promote re-growth of cutaneous small-diameter fibers. Behavioral reduction in periods of seated, awake inactivity produces multimodal metabolic benefits similar to exercise, and the two strategies when combined may offer sustained benefit to peripheral nerve function.
Literature
1.
Dyck PJ, Kratz JM, Karnes JL, et al. The prevalence by staged severity of various types of diabetic neuropathy, retinopathy and nephropathy in a population-based cohort: the Rochester Diabetic Neuropathy Study. Neurology. 1993;43:817–24.CrossRefPubMed
2.
Pop-Busui R, Lu J, Lopes N, et al. Prevalence of diabetic peripheral neuropathy and relation to glycemic control therapies at baseline in the BARI 2D cohort. J Peripher Nerv Syst. 2009;14:1–13.PubMedCentralCrossRefPubMed
3.
Gordois A, Scuffham P, Shearer A, et al. The health care costs of diabetic peripheral neuropathy in the US. Diabetes Care. 2003;26:1790–5.CrossRefPubMed
4.
Guy RJ, Clark CA, Malcolm PN, et al. Evaluation of thermal and vibration sensation in diabetic neuropathy. Diabetologia. 1985;28:131–7.PubMed
5.
Thomas PK. Classification, differential diagnosis, and staging of diabetic peripheral neuropathy. Diabetes. 1997;46 Suppl 2:S54–7.CrossRefPubMed
6.
Kennedy JM, Zochodne DW. Experimental diabetic neuropathy with spontaneous recovery: is there irreparable damage? Diabetes. 2005;54:830–7.CrossRefPubMed
7.
Griffin JW, Thompson WJ. Biology and pathology of nonmyelinating Schwann cells. Glia. 2008;56:1518–31.CrossRefPubMed
8.
Smith AG, Howard JR, Kroll R, et al. The reliability of skin biopsy with measurement of intraepidermal nerve fiber density. J Neurol Sci. 2005;228:65–9.CrossRefPubMed
9.
Lauria G, Bakkers M, Schmitz C, et al. Intraepidermal nerve fiber density at the distal leg: a worldwide normative reference study. J Peripher Nerv Syst. 2010;15:202–7.CrossRefPubMed
10.
Lauria G, Hsieh ST, Johansson O, et al. European Federation of Neurological Societies/Peripheral Nerve Society guideline on the use of skin biopsy in the diagnosis of small fiber neuropathy. Report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society. Eur J Neurol. 2010;17:903–12. e944-909.CrossRefPubMed
11.
Dyck PJ, Norell JE, Tritschler H, et al. Challenges in design of multicenter trials: end points assessed longitudinally for change and monotonicity. Diabetes Care. 2007;30:2619–25.CrossRefPubMed
12.
Costa LA, Canani LH, Lisboa HR, et al. Aggregation of features of the metabolic syndrome is associated with increased prevalence of chronic complications in type 2 diabetes. Diabet Med. 2004;21:252–5.CrossRefPubMed
13.•
Smith AG, Singleton JR. Obesity and hyperlipidemia are risk factors for early diabetic neuropathy. J Diabetes Complicat. 2013;27:436–42. This study demonstrates the epidemiological link between nonglycemic features of metabolic syndrome and diabetic neuropathy.PubMedCentralCrossRefPubMed
14.
Tesfaye S, Stevens LK, Stephenson JM, et al. Prevalence of diabetic peripheral neuropathy and its relation to glycaemic control and potential risk factors: the EURODIAB IDDM Complications Study. Diabetologia. 1996;39:1377–84.CrossRefPubMed
15.
Gaede P, Vedel P, Larsen N, et al. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med. 2003;348:383–93.CrossRefPubMed
16.
Straub RH, Thum M, Hollerbach C, et al. Impact of obesity on neuropathic late complications in NIDDM. Diabetes Care. 1994;17:1290–4.CrossRefPubMed
17.
Tesfaye S, Selvarajah D. The Eurodiab Study: what has this taught us about diabetic peripheral neuropathy? Curr Diab Rep. 2009;9:432–4.CrossRefPubMed
18.
Callaghan B, Feldman E. The metabolic syndrome and neuropathy: therapeutic challenges and opportunities. Ann Neurol. 2013;74:397–403.CrossRefPubMed
19.
Obrosova IG. Diabetic painful and insensate neuropathy: pathogenesis and potential treatments. Neurotherapeutics. 2009;6:638–47.CrossRefPubMed
20.
Watcho P, Stavniichuk R, Ribnicky DM, et al. High-fat diet-induced neuropathy of prediabetes and obesity: effect of PMI-5011, an ethanolic extract of Artemisia dracunculus L. Mediat Inflamm. 2010;2010:268547.CrossRef
21.
Davidson EP, Coppey LJ, Calcutt NA, et al. Diet-induced obesity in Sprague-Dawley rats causes microvascular and neural dysfunction. Diabetes Metab Res Rev. 2010;26:306–18.PubMedCentralCrossRefPubMed
22.
Lupachyk S, Watcho P, Hasanova N, et al. Triglyceride, nonesterified fatty acids, and prediabetic neuropathy: role for oxidative-nitrosative stress. Free Radic Biol Med. 2012;52:1255–63.PubMedCentralCrossRefPubMed
23.•
Groover AL, Ryals JM, Guilford BL, et al. Exercise-mediated improvements in painful neuropathy associated with prediabetes in mice. Pain. 2013;154:2658–67. Behavioral therapy improves indices of neuropathic pain in a mouse model of prediabetic neuropathy.CrossRefPubMed
24.
25.
Guilford BL, Ryals JM, Wright DE. Phenotypic changes in diabetic neuropathy induced by a high-fat diet in diabetic C57BL/6 mice. Exp Diabetes Res. 2011;2011:848307.PubMedCentralCrossRefPubMed
26.
Singleton JR, Smith AG, Russell JW, et al. Microvascular complications of impaired glucose tolerance. Diabetes. 2003;52:2867–73.CrossRefPubMed
27.
Lewis GF, Carpentier A, Adeli K, et al. Disordered fat storage and mobilization in the pathogenesis of insulin resistance and type 2 diabetes. Endocr Rev. 2002;23:201–29.CrossRefPubMed
28.
Oltman CL, Coppey LJ, Gellett JS, et al. Progression of vascular and neural dysfunction in sciatic nerves of Zucker diabetic fatty and Zucker rats. Am J Physiol Endocrinol Metab. 2005;289:E113–22.CrossRefPubMed
29.
Obrosova IG, Drel VR, Oltman CL, et al. Role of nitrosative stress in early neuropathy and vascular dysfunction in streptozotocin-diabetic rats. Am J Physiol Endocrinol Metab. 2007;293:E1645–55.CrossRefPubMed
30.
Esenabhalu VE, Schaeffer G, Graier WF. Free fatty acid overload attenuates Ca(2+) signaling and NO production in endothelial cells. Antioxid Redox Signal. 2003;5:147–53.CrossRefPubMed
31.
Pleiner J, Schaller G, Mittermayer F, et al. FFA-induced endothelial dysfunction can be corrected by vitamin C. J Clin Endocrinol Metab. 2002;87:2913–7.CrossRefPubMed
32.
Vincent AM, McLean LL, Backus C, et al. Short-term hyperglycemia produces oxidative damage and apoptosis in neurons. FASEB J. 2005;19:638–40.PubMed
33.
Ahmed FN, Naqvi FN, Shafiq F. Lipid peroxidation and serum antioxidant enzymes in patients with type 2 diabetes mellitus. Ann N Y Acad Sci. 2006;1084:481–9.CrossRefPubMed
34.
Cruz NG, Sousa LP, Sousa MO, et al. The linkage between inflammation and type 2 diabetes mellitus. Diabetes Res Clin Pract. 2013;99:85–92.CrossRefPubMed
35.
Boyanovsky B, Karakashian A, King K, et al. Uptake and metabolism of low density lipoproteins with elevated ceramide content by human microvascular endothelial cells: implications for the regulation of apoptosis. J Biol Chem. 2003;278:26992–9.CrossRefPubMed
36.
Cheng HT, Dauch JR, Hayes JM, et al. Nerve growth factor/p38 signaling increases intraepidermal nerve fiber densities in painful neuropathy of type 2 diabetes. Neurobiol Dis. 2012;45:280–7.PubMedCentralCrossRefPubMed
37.
Casanova-Molla J, Morales M, Planas-Rigol E, et al. Epidermal Langerhans cells in small fiber neuropathies. Pain. 2012;153:982–9.CrossRefPubMed
38.
Dauch JR, Bender DE, Luna-Wong LA, et al. Neurogenic factor-induced Langerhans cell activation in diabetic mice with mechanical allodynia. J Neuroinflammation. 2013;10:64.PubMedCentralCrossRefPubMed
39.
Diabetes Control and Complications Trial Research Group. The effect of intensive diabetes therapy on the development and progression of neuropathy. Ann Intern Med. 1995;122:561.CrossRef
40.
Ismail-Beigi F, Craven T, Banerji MA, et al. Effect of intensive treatment of hyperglycaemia on microvascular outcomes in type 2 diabetes: an analysis of the ACCORD randomised trial. Lancet. 2010;376:419–30.PubMedCentralCrossRefPubMed
41.
Callaghan BC, Little A, Feldman E, et al. Enhanced glycemic control for preventing and treating diabetic neuropathy. Cochrane Database Syst Rev. 2012; in press.
42.
Yagihashi S, Yamagishi SI, Wada Ri R, et al. Neuropathy in diabetic mice overexpressing human aldose reductase and effects of aldose reductase inhibitor. Brain. 2001;124:2448–58.CrossRefPubMed
43.
Krentz AJ, Honigsberger L, Ellis SH, et al. A 12-month randomized controlled study of the aldose reductase inhibitor ponalrestat in patients with chronic symptomatic diabetic neuropathy. Diabet Med. 1992;9:463–8.CrossRefPubMed
44.
Coppey LJ, Davidson EP, Rinehart TW, et al. ACE inhibitor or angiotensin II receptor antagonist attenuates diabetic neuropathy in streptozotocin-induced diabetic rats. Diabetes. 2006;55:341–8.CrossRefPubMed
45.
Malik R, Williamson S, Abbott C. Effect of the angiotensin converting enzyme inhibitor trandoalapril on human diabetic neuropathy: a randomised controlled trial. Lancet. 1998;352:1978–81.CrossRefPubMed
46.
Ziegler D, Gries FA. Alpha-lipoic acid in the treatment of diabetic peripheral and cardiac autonomic neuropathy. Diabetes. 1997;46:S62–6.CrossRefPubMed
47.
Ziegler D, Nowak H, Kempler P, et al. Treatment of symptomatic diabetic polyneuropathy with the antioxidant alpha-lipoic acid: a meta-analysis. Diabet Med. 2004;21:114–21.CrossRefPubMed
48.
Cameron N, Tuck S, McCabe L, et al. Effects of the hydroxyl radical scavenger, dimethylthiorurea, on peripheral nerve tissue perfusion, conduction velocity and nociception in experimental diabetes. Diabetologia. 2001;44:1161–9.CrossRefPubMed
49.
Greene DA, Arezzo JC, Brown MB. Effect of aldose reductase inhibition on nerve conduction and morphometry in diabetic neuropathy. Zenarestat Study Group. Neurology. 1999;53:580–91.CrossRefPubMed
50.
Kihara M, Mitsui Y, Shioyama M, et al. Effect of zenarestat, an aldose reductase inhibitor, on endoneurial blood flow in experimental diabetic neuropathy of rat. Neurosci Lett. 2001;310:81–4.CrossRefPubMed
51.
Pfeifer MA, Schumer MP. Clinical trials of diabetic neuropathy: past present and future. Diabetes. 1995;44:1355–61.CrossRefPubMed
52.
Mojaddidi M, Quattrini C, Tavakoli M, et al. Recent developments in the assessment of efficacy in clinical trials of diabetic neuropathy. Curr Diab Rep. 2005;5:417–22.CrossRefPubMed
53.
Malik RA, Tesfaye S, Newrick PG, et al. Sural nerve pathology in diabetic patients with minimal but progressive neuropathy. Diabetologia. 2005;48:578–85.CrossRefPubMed
54.
Simone DA, Nolano M, Johnson T, et al. Intradermal injection of capsaicin in humans produces degeneration and subsequent reinnervation of epidermal nerve fibers: correlation with sensory function. J Neurosci. 1998;18:8947–59.PubMed
55.
Polydefkis M, Hauer P, Sheth S, et al. The time course of epidermal nerve fibre regeneration: studies in normal controls and in people with diabetes, with and without neuropathy. Brain. 2004;127:1606–15.CrossRefPubMed
56.•
Singleton JR, Marcus RL, Lessard MK, et al. Supervised exercise improves cutaneous reinnervation capacity in metabolic syndrome patients. Ann Neurol. 2015;77:146–53. Exercise alters the biology of cutaneous nociceptive fibers in the absence of neuropathy disease state.CrossRefPubMed
57.
Huang HH, Farmer K, Windscheffel J, et al. Exercise increases insulin content and basal secretion in pancreatic islets in type 1 diabetic mice. Exp Diabetes Res. 2011;2011:481427.PubMedCentralPubMed
58.
Kiraly MA, Bates HE, Yue JT, et al. Attenuation of type 2 diabetes mellitus in the male Zucker diabetic fatty rat: the effects of stress and non-volitional exercise. Metabolism. 2007;56:732–44.CrossRefPubMed
59.
Chen YW, Li YT, Chen YC, et al. Exercise training attenuates neuropathic pain and cytokine expression after chronic constriction injury of rat sciatic nerve. Anesth Analg. 2012;114:1330–7.CrossRefPubMed
60.
Sharma NK, Ryals JM, Gajewski BJ, et al. Aerobic exercise alters analgesia and neurotrophin-3 synthesis in an animal model of chronic widespread pain. Phys Ther. 2010;90:714–25.PubMedCentralCrossRefPubMed
61.
Selagzi H, Buyukakilli B, Cimen B, et al. Protective and therapeutic effects of swimming exercise training on diabetic peripheral neuropathy of streptozotocin-induced diabetic rats. J Endocrinol Investig. 2008;31:971–8.CrossRef
62.
Orchard TJ, Temprosa M, Goldberg R, et al. The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program randomized trial. Ann Intern Med. 2005;142:611–9.PubMedCentralCrossRefPubMed
63.
Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393–403.CrossRefPubMed
64.
Tuomilehto J, Del Prato S. Mealtime glucose regulation in type 2 diabetes. Int J Clin Pract. 2001;55:380–3.PubMed
65.•
Balducci S, Iacobellis G, Parisi L, et al. Exercise training can modify the natural history of diabetic peripheral neuropathy. J Diabetes Complicat. 2006;20:216–23. First study to show effect of exercise on diabetic neuropathy prevention.CrossRefPubMed
66.
Singleton JR, Marcus RL, Jackson JE, et al. Exercise increases cutaneous nerve density in diabetic patients without neuropathy. Ann Clin Transl Neurol. 2014;1:844–9.PubMedCentralCrossRefPubMed
67.
Allet L, Armand S, de Bie RA, et al. The gait and balance of patients with diabetes can be improved: a randomised controlled trial. Diabetologia. 2010;53:458–66.PubMedCentralCrossRefPubMed
68.
69.
Smith AG, Russell J, Feldman EL, et al. Lifestyle intervention for pre-diabetic neuropathy. Diabetes Care. 2006;29:1294–9.CrossRefPubMed
70.•
Kluding PM, Pasnoor M, Singh R, et al. The effect of exercise on neuropathic symptoms, nerve function, and cutaneous innervation in people with diabetic peripheral neuropathy. J Diabetes Complicat. 2012. First human study to demonstrate improvement in diabetic neuropathy indices with exercise.
71.
Kluding PM, Pasnoor M, Singh R, et al. Safety of aerobic exercise in people with diabetic peripheral neuropathy: single-group clinical trial. Phys Ther. 2015;95:223–34.CrossRefPubMed
72.
Yoo M, D’Silva LJ, Martin K, et al. Pilot study of exercise therapy on painful diabetic peripheral neuropathy. Pain Med. 2015;16:1482–9.CrossRefPubMed
73.
Morrison S, Colberg SR, Parson HK, et al. Exercise improves gait, reaction time and postural stability in older adults with type 2 diabetes and neuropathy. J Diabetes Complicat. 2014;28:715–22.CrossRefPubMed
74.•
Handsaker JC, Brown SJ, Bowling FL, et al. Contributory factors to unsteadiness during walking up and down stairs in patients with diabetic peripheral neuropathy. Diabetes Care. 2014;37:3047–53. Careful study of physical contributors to altered balance in diabetic neuropathy.CrossRefPubMed
75.
Handsaker JC, Brown SJ, Bowling FL, et al. Resistance exercise training increases lower limb speed of strength generation during stair ascent and descent in people with diabetic peripheral neuropathy. Diabet Med. 2015. doi:10.​1111/​dme.​12841.
76.
Streckmann F, Zopf EM, Lehmann HC, et al. Exercise intervention studies in patients with peripheral neuropathy: a systematic review. Sports Med. 2014;44:1289–304.CrossRefPubMed
77.
Lemaster JW, Mueller MJ, Reiber GE, et al. Effect of weight-bearing activity on foot ulcer incidence in people with diabetic peripheral neuropathy: feet first randomized controlled trial. Phys Ther. 2008;88:1385–98.CrossRefPubMed
78.
Armstrong DG, Lavery LA, Holtz-Neiderer K, et al. Variability in activity may precede diabetic foot ulceration. Diabetes Care. 2004;27:1980–4.CrossRefPubMed
79.
Kruse RL, Lemaster JW, Madsen RW. Fall and balance outcomes after an intervention to promote leg strength, balance, and walking in people with diabetic peripheral neuropathy: “feet first” randomized controlled trial. Phys Ther. 2010;90:1568–79.CrossRefPubMed
80.
Donnelly JE, Blair SN, Jakicic JM, et al. American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc. 2009;41:459–71.CrossRefPubMed
81.
Praet SF, van Rooij ES, Wijtvliet A, et al. Brisk walking compared with an individualised medical fitness programme for patients with type 2 diabetes: a randomised controlled trial. Diabetologia. 2008;51:736–46.PubMedCentralCrossRefPubMed
82.
Tremblay M, Sedentary Behaviour Research N. Letter to the editor: standardized use of the terms “sedentary” and “sedentary behaviours”. Appl Physiol Nutr Metab. 2012;37:540–2.CrossRef
83.
Koster A, Caserotti P, Patel KV, et al. Association of sedentary time with mortality independent of moderate to vigorous physical activity. PLoS One. 2012;7, e37696.PubMedCentralCrossRefPubMed
84.
Bey L, Hamilton MT. Suppression of skeletal muscle lipoprotein lipase activity during physical inactivity: a molecular reason to maintain daily low-intensity activity. J Physiol. 2003;551:673–82.PubMedCentralCrossRefPubMed
85.
Hamilton MT, Hamilton DG, Zderic TW. Role of low energy expenditure and sitting in obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease. Diabetes. 2007;56:2655–67.CrossRefPubMed
86.
Harrison M, O’Gorman DJ, McCaffrey N, et al. Influence of acute exercise with and without carbohydrate replacement on postprandial lipid metabolism. J Appl Physiol (1985). 2009;106:943–9.CrossRef
87.
Stephens BR, Granados K, Zderic TW, et al. Effects of 1 day of inactivity on insulin action in healthy men and women: interaction with energy intake. Metabolism. 2011;60:941–9.CrossRefPubMed
88.
Thorp AA, Owen N, Neuhaus M, et al. Sedentary behaviors and subsequent health outcomes in adults a systematic review of longitudinal studies, 1996-2011. Am J Prev Med. 2011;41:207–15.CrossRefPubMed
89.
Duvivier BM, Schaper NC, Bremers MA, et al. Minimal intensity physical activity (standing and walking) of longer duration improves insulin action and plasma lipids more than shorter periods of moderate to vigorous exercise (cycling) in sedentary subjects when energy expenditure is comparable. PLoS One. 2013;8, e55542.PubMedCentralCrossRefPubMed
90.
91.
Nygaard H, Tomten SE, Hostmark AT. Slow postmeal walking reduces postprandial glycemia in middle-aged women. Appl Physiol Nutr Metab. 2009;34:1087–92.CrossRefPubMed
92.
Healy GN, Wijndaele K, Dunstan DW, et al. Objectively measured sedentary time, physical activity, and metabolic risk: the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Diabetes Care. 2008;31:369–71.CrossRefPubMed
93.
Dunstan DW, Kingwell BA, Larsen R, et al. Breaking up prolonged sitting reduces postprandial glucose and insulin responses. Diabetes Care. 2012;35:976–83.PubMedCentralCrossRefPubMed
94.
Cooper JN, Columbus ML, Shields KJ, et al. Effects of an intensive behavioral weight loss intervention consisting of caloric restriction with or without physical activity on common carotid artery remodeling in severely obese adults. Metabolism. 2012;61:1589–97.PubMedCentralCrossRefPubMed
95.
Gardiner PA, Eakin EG, Healy GN, et al. Feasibility of reducing older adults’ sedentary time. Am J Prev Med. 2011;41:174–7.CrossRefPubMed
96.
De Greef KP, Deforche BI, Ruige JB, et al. The effects of a pedometer-based behavioral modification program with telephone support on physical activity and sedentary behavior in type 2 diabetes patients. Patient Educ Couns. 2011;84:275–9.CrossRefPubMed
97.
Lyden K, Kozey Keadle SL, Staudenmayer JW, et al. Validity of two wearable monitors to estimate breaks from sedentary time. Med Sci Sports Exerc. 2012;44:2243–52.PubMedCentralCrossRefPubMed
98.
Kozey-Keadle S, Libertine A, Lyden K, et al. Validation of wearable monitors for assessing sedentary behavior. Med Sci Sports Exerc. 2011;43:1561–7.CrossRefPubMed
99.
Kozey-Keadle S, Libertine A, Staudenmayer J, et al. The feasibility of reducing and measuring sedentary time among overweight, non-exercising office workers. J Obes 2012; 2012: 282303.
Metadata
Title
Exercise as Therapy for Diabetic and Prediabetic Neuropathy
Authors
J. Robinson Singleton
A. Gordon Smith
Robin L. Marcus
Publication date
01-12-2015
Publisher
Springer US
Published in
Current Diabetes Reports / Issue 12/2015
Print ISSN: 1534-4827
Electronic ISSN: 1539-0829
DOI
https://doi.org/10.1007/s11892-015-0682-6

Other articles of this Issue 12/2015

Current Diabetes Reports 12/2015 Go to the issue

Health Care Delivery Systems and Implementation in Diabetes (EB Morton-Eggleston, Section Editor)

Shared Decision-Making in Diabetes Care

Diabetes Epidemiology (NM Maruthur, Section Editor)

Betatrophin in Diabetes Mellitus: the Epidemiological Evidence in Humans

Microvascular Complications—Retinopathy (JK Sun, Section Editor)

Hypoxia and Dark Adaptation in Diabetic Retinopathy: Interactions, Consequences, and Therapy

Pathogenesis of Type 1 Diabetes (A Pugliese, Section Editor)

Molecular Interactions Governing Autoantigen Presentation in Type 1 Diabetes

Macrovascular Complications in Diabetes (VR Aroda and A Getaneh, Section Editors)

Epigenetics and Cardiovascular Disease in Diabetes

Treatment of Type 1 Diabetes (M Pietropaolo, Section Editor)

Lessons From Pancreas Transplantation in Type 1 Diabetes: Recurrence of Islet Autoimmunity
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits